On the detransition: the motives of patients and the legal procedure

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D'yachenko AV, Bukhanovskaya OA, Loskutova AS, et al. [On the detransition: the motives of patients and the legal procedure]. Rossiiskii psikhiatricheskii zhurnal [Russian Journal of Psychiatry]. 2025;(5):38-55. Russian

Abstract

The phenomenon of «reverse» gender reassignment – that is, the voluntary return of patients who have resorted to gender transformation in the past to their natal gender – has been frequently mentioned in recent years both in the scientific literature and in the media. A significant increase in such cases compared to previous follow-up periods raises questions about the adequacy of approaches to the diagnosis and treatment of gender identity disorders. The article presents the first case of detransition after the entry into force of Federal Law No 386-FL dated 07.24.2023 «On Amendments to Certain Legislative Acts of the Russian Federation».

Keywords transsexualism; transgenderism; gender change; detransition

References

1. Dyachenko AV, Bukhanovskaya OA, Soldatkin VA, Perekhov AY. [Who Submits a Request to the Psychiatrist for a Gender Change: Results of a 30-Year Study]. Psikhiatriya. 2020;18(3):32–41. (In Russ.) DOI: 10.30629/2618-6667-2020-18-3-32-41 2. Dhejne C, Oberg K, Arver S, Landen M. An analysis of all applications for sex reassignment surgery in Sweden, 1960–2010: Prevalence, incidence, and regrets. Archives of Sexual Behavior. 2014;43(8):1535–45. DOI: 10.1007/s10508-014-0300-8 3. Wiepjes CM, Nota NM, de Blok CJM, Klaver M, de Vries ALC, Wensing-Kruger SA, de Jongh RT, Bouman MB, Steensma TD, Cohen-Kettenis PT, Gooren LJG, Kreukels BPC, den Heijer M. The Amsterdam Cohort of Gender Dysphoria Study (1972–2015): Trends in prevalence, treatment, and regrets. Journal of Sexual Medicine. 2018;15(4):582–90. DOI: 10.1016/j.jsxm.2018.01.016 4. Wiepjes CM, den Heijer M, Bremmer MA, Nota NM, de Blok CJM, Coumou BJG, Steensma TD. Trends in suicide death risk in transgender people: results from the Amsterdam Cohort of Gender Dysphoria study (1972–2017). Acta Psychiatrica Scandinavica. 2020;141(6):486–91. DOI: 10.1111/acps.13164 5. Marchiano L. Outbreak: On transgender teens and psychic epidemics. Psychological Perspectives: A Quarterly Journal of Jungian Thought. 2017;60(3):345–66. DOI: 10.1080/00332925.2017.1350804 6. Expósito-Campos P, Gómez-Balaguer M, Hurtado-Murillo F, García-Moreno RM, Morillas-Ariño C. Medical detransition following transgender identity reaffirmation: two case reports. Sexual Health. 2021;18(6):498–501. DOI: 10.1071/SH21089 7. Littman L. Individuals treated for gender dysphoria with medical and/or surgical transition who subsequently detransitioned: A survey of 100 detransitioners. Archives of Sexual Behavior. 2021;50(8):3353–69. DOI: 10.1007/s10508-021-02163-w 8. Respaut R, Terhune C, Conlin M. Why detransitioners are crucial to the science of gender care. Reuters. 2022. URL: https://www.reuters.com/investigates/special-report/usa-transyouth-outcomes/ (accessed on: 02.19.2025). 9. Callahan C. Unheard voices of detransitioners. In H. Brunskell-Evans & M. Moore, Transgender children and young people: Born in your own body. Cambridge Scholars Publishing. 2018. Р. 166–180. 10. D’Angelo R. Psychiatry’s ethical involvement in gender-affirming care. Australasian Psychiatry. 2018;26(5):460–3. DOI: 10.1177/1039856218775216 11. Djordjevic ML, Bizic MR, Duisin D, Bouman MB, Buncamper M. Reversal surgery in regretful male-to-female transsexuals after sex reassignment surgery. Journal of Sexual Medicine. 2016;13(6):1000–7. DOI: 10.1016/j.jsxm.2016.02.173 12. Levine SB. Transitioning back to maleness. Archives of Sexual Behavior. 2018;47(4):1295–300. DOI: 10.1007/s10508-017-1136-9 13. Pazos GM, Gómez Balaguer M, Gomes PM, Hurtado MF, Solá IE, Morillas AC. Transexualidad: Transiciones, detransiciones y arrepentimientos en España. Endocrinología, Diabetes y Nutrición. 2020;67(9):562–7. DOI: 10.1016/j.endinu.2020.03.008 14. Stella C. Female detransition and reidentification: Survey results and interpretation. 2016. URL: http://guideonragingstars.tumblr.com/post/149877706175/female-detransition-and-reidentification-survey (accessed on: 02.19.2025). 15. Turban JL, Keuroghlian AS. Dynamic gender presentations: Understanding transition and «de-transition» among transgender youth. Journal of the American Academy of Child and Adolescent Psychiatry. 2018;57(7):451–3. DOI: 10.1016/j.jaac.2018.03.016 16. Turban JL, Loo SS, Almazan AN, Keuroghlian AS. Factors leading to «detransition» among transgender and gender diverse people in the United States: A mixed-methods analysis. LGBT Health. 2021;8:273–80. DOI: 10.1089/lgbt.2020.0437 17. Marchiano L. The ranks of gender detransitioners are growing. We need to understand why. Quilette. 2020. URL: https://quillette.com/2020/01/02/the-ranks-of-gender-detransitioners-are-growing-we-need-to-understand-why/ (accessed on: 02.10.2025). 18. Vandenbussche E. Detransition-related needs and support: A cross-sectional online survey. Journal of Homosexuality. 2021;69(9):1602–20. DOI: 10.1080/00918369.2021.1919479 19. Dolotina B, Daniolos PT. Dynamic Gender Identities and Expressions: Detransition and Affirming Non-linear Gender Pathways Among Transgender and Gender Diverse Child and Adolescent Psychiatric Clinics of North America. 2023;32(4):803–13. DOI: 10.1016/j.chc.2023.05.002 20. Hall R, Mitchell L, Sachdeva J. Access to care and frequency of detransition among a cohort discharged by a UK national adult gender identity clinic: Retrospective case-note review. BJPsych Open. 2021;7(6): e184. DOI: 10.1192/bjo.2021.1022 21. Boyd I, Hackett T, Bewley S. Care of transgender patients: A general practice quality improvement approach. Healthcare. 2022;10(1). DOI: 10.3390/healthcare10010121 22. Butler G, Adu-Gyamfi K, Clarkson K, El Khairi R, Kleczewski S, Roberts A, Segal TY, Yogamanoharan K, Alvi S, Amin N, Carruthers P, Dover S, Eastman J, Mushtaq T, Masic U, Carmichael P. Discharge outcome analysis of 1089 transgender young people referred to paediatric endocrine clinics in England 2008–2021. Archives of Disease in Childhood. 2022;107(11):1018–22. DOI: 10.1136/archdischild-2022-324302 23. Cohen A, Gomez-Lobo V, Willing L, Call D, Damle LF, D’Angelo LJ, Song A, Strang JF. Shifts in gender-related medical requests by transgender and gender-diverse adolescents. Journal of Adolescent Health. 2023;72(3):428–36. DOI: 10.1016/j.jadohealth.2022.10.020 24. Roberts CM, Klein DA, Adirim TA, Schvey NA, Hisle-Gorman E. Continuation of gender-affirming hormones among transgender adolescents and adults. Journal of Clinical Endocrinology & Metabolism. 2022;107(9):e3937–43. DOI: 10.1210/clinem/dgac251 25. Olson KR, Durwood L, Horton R, Gallagher NM, Devor A. Gender identity 5 years after social transition. Pediatrics. 2022;150(2):e2021056082. DOI: 10.1542/peds.2021-056082 26. Irwig MS. Detransition Among Transgender and Gender-Diverse People –An Increasing and Increasingly Complex Phenomenon. The Journal of Clinical Endocrinology & Metabolism. 2022;107(10):4261–2. DOI: 10.1210/clinem/dgac356 27. MacKinnon KR, Kia H, Salway T, Ashley F, Lacombe-Duncan A, Abramovich A, Enxuga G, Ross LE. Health care experiences of patients discontinuing or reversing prior gender-affirming treatments. JAMA Network Open, 2022;5(7):e2224717. DOI: 10.1001/jamanetworkopen.2022.24717 28. Herzog K. The detransitioners: They were transgender until they weren’t. The Stranger. 2017. URL: https://www.thestranger.com/features/2017/06/28/25252342/the detransitioners-they-were-transgender-until-they-werent (accessed on: 02.11.2025). 29. Bridge L. Detransitioners are living proof the practices surrounding «trans kids» need to be questioned. Feminist Current. 2020. URL: https://www.feministcurrent.com/2020/01/09/detransitioners-are-living-proof-the-practices-surrounding-trans-kids-need-be-questioned/ (accessed on: 02.19.2025). 30. Kibrik ND, Yagubov MI, Zhuravel AP. Sexual identification disorders: diagnostic errors and patient management tactics. Social and clinical Psychiatry. 2017;27(4):63–9. 31. Mendelevich VD. Why transsexualism is not a mental disorder, or how to make psychiatric classification scientific. Neurological Bulletin. 2018;L(3):5–10. (In Russ.) 32. Sivolap YuP. Gender dysphoria in ICD-11: is psychiatry really dying? Report at the Psychiatric Generations in Search of Consensus conference. Kazan, December 1, 2021. URL: https://rutube.ru/video/9ca9f2ead5f4a2e6787fadc1baa1af51/ (accessed on: 03.11.2025) (In Russ.) 33. Matevosyan SN, Vvedensky GE. Sexual dysphoria (clinical and phenomenological features and therapeutic and rehabilitation aspects of the syndrome of «rejection» of sex). Moscow: LLC «Medical Information Agency»; 2012. 400 p. (In Russ.) 34. Vvedenskiy GE. The phenomenology of sex reassignment ideas in patients with schizotypal disorder. Medical Bulletin of the South of Russia. 2022;13(3):32–5. (In Russ.) 35. Popova GA. Disorder of sexual self-identification in the framework of non-psychotic forms of endogenous diseases and personality disorders [dissertation]. [Moscow (Russia)]; 2020. 218 p. (In Russ.) 36. Dyachenko A.V. Transsexual-like states in schizotypal disorder in adolescents: statics, dynamics, therapy [dissertation]. [Moscow (Russia)]; 2024. 313 p. (In Russ.) 37. Kibrik ND, Vvedenskiy GE, Matevosyan SN, Yagubov MI. Sexual identification disorders: clinical issues and patient management tactics. Methodological recommendations. Moscow, 2018. 27 p. (In Russ.) 38. D'yachenko AV, Bukhanovskaya OA, Soldatkin VA, et al. [The case of mistaken diagnosis of transsexualism in a patient with schizotypal disorder]. Rossiiskii psikhiatricheskii zhurnal [Russian Journal of Psychiatry]. 2021;(2):73–83. (In Russ.) 39. Zucker KJ, Bradley SJ. Gender identity disorders and psychosexual problems in adolescents. Moscow: Gorodets Publishing House; 2020. 640 p. (In Russ.) 40. Bukhanovsky AO. Transsexualism: clinic, systematics, differential diagnosis, psychosocial readaptation and rehabilitation: [PhD thesis]. [Moscow (Russia)]; 1994. 25 p. (In Russ.) 41. Vinogradova NA. Formation of gender identity. Methodical manual. Moscow: Sphere Shopping Center; 2012. 118 p. (In Russ.) 42. Kolominsky YaL. Role differentiation of gender in preschoolers. Questions of psychology. 2005;3:165–71. (In Russ.) 43. Kagan VE. Cognitive and emotional aspects of gender attitudes in children aged 3–7 years. Questions of psychology. 2010;2:18–22. (In Russ.) 44. Belopolskaya NL. Gender and age identification. Methodology for the study of children's self–awareness. Moscow: Kogito-Center; 2008. 24 p. (In Russ.) 45. D'yachenko AV, Bukhanovskaya OA, Soldatkin VA, et al. [Clinical and dynamic characteristics of transsexual-like states in schizotypal disorder in adolescents]. Rossiiskii psikhiatricheskii zhurnal [Russian Journal of Psychiatry]. 2022;(2):77–93. (In Russ.) 46. Tsutsulkovskaya M.Ya. Schizophrenia, occurring in the form of an atypical prolonged puberty attack. Handbook of Psychiatry. In 2 volumes. Vol. 1. Edited by A.S. Tiganov. Moscow: Medicine; 1999. Р. 446–57. (In Russ.) 47. Drummond KD, Bradley SJ, Peterson-Change M, et al. A follow-up study of girls with gender identity disorder. Dev Psychol. 2008;44:34–45. 48. Steensma TD, McGuire JK, Wrinkles BP, et al. Factors associated with desistence and persistence of childhood gender dysphoria: A quantitative follow-up study. J Am Acad Child Adolesc Psychiatry 2013;52:582–90. 49. Walloon MS, Cohen-Kettenis PT. Psychosexual outcome of gender-dysphoric children. J. Am Acad Child Adolesc Psychiatry. 2008;47:1413–23. 50. Vvedensky GE, Matevosyan SN. Sexual Disorders in the ICD-11 Project: Methodological and Clinical Issues. Social and Clinical Psychiatry. 2017;27(3):102–5. (In Russ.) 51. Dyachenko AV, Perekhov AY, Soldatkin VA, Bukhanovskaya Gender Identity Disorders: Current Medical and Social Paradigm and the ICD-11 Innovations. Consortium Psychiatricum. 2021;2(2):54–64. 52. Starostina EA. Features of Gender Identity Disorders in Schizophrenic Spectrum Disorders in Comparison with Transsexuality. Bulletin of Neurology, Psychiatry, and Neurosurgery. 2023;3:15–24. (In Russ.) DOI: 10.33920/med-01-2303-02 53. Belkin AI, Karpov AS. Transexuality: Methodological Recommendations for Gender Reassignment. Moscow, 1991. 21 p. (In Russ.) 54. Bukhanovsky AO, Spiridonova NV. Transexuality or Schizophrenia? Were There Any Reasons for Gender Reassignment. Independent Psychiatric Journal. 2011;2:23–32. (In Russ.) 55. Perekhov AYa. Clinic and dynamics of fetish transvestism with the syndrome of rejection of sex [PhD thesis]. [Moscow (Russia)]; 1996. 21 p. (In Russ.) 56. Bukhanovsky AO. Transsexualism and similar conditions. Rostov-on-Don: Ed. Mini Type; 2016. 580 p. (In Russ.)

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